№ lp_1_2_35692
This document is a health and safety risk assessment form for workstation evaluation of display screen equipment (DSE), outlining required adjustments and checks for a safe working environment.
Year: 2018
Revised Date: October 2023
Source of Risk: Display Screen Equipment
Risk Type: Health and Safety Risk Assessment
Objective being impacted: Compliance with OSH legislation and the maintenance of a safe and healthy work environment
Risk Co-Ordinator: N/A for OSH Risk Assessments
DSE Risk Assessor(s): [Name of Risk Assessor]
DSE User’s Name: [Enter DSE User’s Name]
Workstation Location: [Enter Workstation Location]
Tasks Undertaken: [Enter Tasks Undertaken]
Dominant Hand: [R/L/Both]
Requires glasses: [Yes/No]
Approximate length of time spent at DSE: [1-2 hours/3-5 hours/>5 hours]
Hospital Site/Service: [Enter Hospital Site/Service]
Name of Risk Owner: [Enter Name of Risk Owner]
Date of Assessment: [Enter Date]
Signature of Risk Owner: [Enter Signature]
Date of Changes: [Enter Date of Changes]
Price: 8 / 10 USD
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